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Noncontrast CT – Stroke Nursing Care in ER

by Rhonda Lawes

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    00:01 So we talked about a noncontrast head CT, right? That's one of the orders that we said. That's a priority. So, you're going to transport Mr. Johnson for a noncontrast head CT, with continuous cardiac monitoring, pulse, oximetry, and oxygen.

    00:17 So what this means is you and Mr. Johnson are going to be traveling, right? So, the gurney, we'll put the bedrails up, and you're wheeling with him. The reason a nurse is going to go with him is because he's not stable, right? We know that he's in atrial fib and we know he's shown some neuro changes. This isn't a patient that should go with a tech or just with someone who's transporting. This patient, Mr. Johnson, deserves a nurse's constant assessment with him. Now, let's talk about what the purpose of this test is in diagnosing an acute stroke.

    00:49 A noncontrast CT might identify the early signs of a stroke, but most importantly, it'll rule out an intracerebral hemorrhage or some other cause for Mr. Johnson's symptoms, like, maybe it's a tumor. So a CTA has this rapid injection of IV contrast and shows you these CAT scan images. It gives you even more detail, but it's not often readily available.

    01:12 So, usually, it will be a noncontrast head CT.

    01:16 So why are we taking Mr. Johnson there? Well, because of the symptoms that he's showing us, we think it's likely a stroke. But we want to rule out that he has an intracerebral hemorrhage, or maybe something unusual, like a tumor that just now started to exhibit these symptoms. So, that's why we're going, and you're going with him to keep a very close eye on him.

    01:37 Okay. So, we're back from CAT scan, but let's review, kind of, the steps that we've gone through. Mr. Johnson started showing symptoms at home.

    01:45 His wife knew how to do the FAST screening. She realized she needed to call 911.

    01:51 She called 911. He was transported to the ER. The ER nurse got report from the paramedics, and they knew right away that they needed to get him to CAT scan.

    02:01 Collaborated with a healthcare professional, and took you right to CAT scan. You went with him because he was unstable with his -- worried about blood pressure, oxygenation, and his rhythm because he was in atrial fib, and he had all of those neuro symptoms. So, you transported, went with him, stayed with him during the test, came back to his ER bay. Now we've got the results of the CAT scan.


    About the Lecture

    The lecture Noncontrast CT – Stroke Nursing Care in ER by Rhonda Lawes is from the course Neurology Case Study: Nursing Care of Stroke Patient.


    Included Quiz Questions

    1. It can identify early signs of a stroke.
    2. It can rule out intracerebral hemorrhage.
    3. It can identify a previous stroke.
    4. It can determine the location of a clot.
    5. It can rule out TIAs.
    1. He is unstable and needs to be accompanied by an RN.
    2. He requested the presence of an RN because he is claustrophobic.
    3. Mr. Johnson will need another IV started for the procedure, and the RN has to start it.
    4. It is not necessary to accompany Mr. Johnson if he is connected to telemetry monitors.

    Author of lecture Noncontrast CT – Stroke Nursing Care in ER

     Rhonda Lawes

    Rhonda Lawes


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